Intraoperative placement of transpyloric jejunal feeding catheters in children

Transpyloric jejunal feeding catheters (TPJC) were placed in 45 children at the time of fundoplication and gastrostomy via the gastrostomy and exteriorized through the abdominal wall in close proximity to the gastrostomy tube. Forty-three children received full enteral nutritional support until gastrostomy tube or oral feeding was established. Thirty-two children receiving essential preoperative oral bronchodilator or anticonvulsant therapy had these medications continued via the TPJC commencing in the immediate postoperative period. The technique of catheter placement and a protocol for usage are presented. There were no complications related to PTJC placement or use. We conclude that PTJC is a useful adjunct to the care of children requiring fundoplication and gastrostomy. These catheters permit: (1) the early postoperative institution of full enteral nutritional support; (2) the continuation of essential oral medications by the enteral route during postoperative recovery; and (3) the early discontinuation of intravenous access.